Maybe because the hangover after a night of GHB clubbing isn't as severe as for alcohol, people underestimate the addictive dangers of club drug GHB – but GHB, when taken to excess over a period of weeks, can cause a psychological and physical addiction, with a serious syndrome of withdrawals.
Heavy regular users of GHB will develop a tolerance to the intoxicating effects of the drug, and will need to take more and more GHB to get the same high. The beginnings of tolerance are the beginnings of addiction, and an addiction to GHB can happen fast.
Casual users are not greatly at risk for addiction (although they are at risk for a potentially fatal overdose) but anyone taking the drug daily, or especially if consuming the drug more than once a day for a period of weeks, will likely develop a physical dependence on the drug.
Once addicted, any attempt to stop using the drug will result in an almost immediate progression into withdrawal symptoms (in as little as one hour). Symptoms of withdrawal will vary in intensity depending on the length and intensity of the GHB habit, but will last from between 5 and 15 days, and can include insomnia, anxiety, tachycardia, sweating, psychosis, bone and muscle pains, tremor, confusion, nausea and vomiting. At least one patient is thought to have died from severe GHB withdrawals.
At best, a GHB withdrawal should occur in a hospital or inpatient psychiatric facility. Some patients experience hallucinations so severe as to need chemical or physical restraints.
GHB in the Brain
GHB gets you high through interactions with multiple neuro-transmitting systems in the brain, thus accounting for the peculiar sensation of speeding and slowing simultaneously while high.
GHB interacts with the GABA systems of the brain, accounting for much of its sedative effects. The GABA system is the same as is affected by alcohol or benzodiazepines, and although the interactions with GHB are slightly different, the syndromes of withdrawal off of drugs like alcohol and GHB are quite similar - and dangerous. GHB slows neural GABA systems down, and after habitual use, without GHB in the brain, the GABA systems will "overreact" causing a neural speeding, and creating withdrawal symptoms such as tremors and anxiety.
GHB also interacts directly with dopaminergic systems in the brain (alcohol does not) and it is speculated that the intense and dangerous hallucinations experienced in severe withdrawals results from a distortion in these dopaminergic systems.
GHB Psychological Addiction (Habituation)
In addition to the development of a serious and possibly dangerous physical addiction, heavy GHB users will likely develop a psychological addiction to the GHB high.
Habituation to using GHB in social situations can lead to anxiety when not on GHB, and cravings to use the drug can persist for long after a physical recovery from withdrawal.
GHB detox and withdrawal should occur under medical supervision. GHB addiction treatment should not end with the cessation of medical supervision. At best, GHB addicts need to learn why they abuse drugs, learn to recognize what in their past, environment or character causes a need for excessive intoxication, and learn what they will need to do to stay addiction free for good.
GHB addicts in recovery will need either intensive outpatient addiction therapy, or better, the intensity of a residential drug rehab.
Page last updated Sep 16, 2010